There’s a reason no one washes a rental car

Butch Mazzuca
Butch Mazzuca |

Harvard’s president emeritus, Lawrence Summers, once said, “In the history of the world, no one has ever washed a rented car.”

Why? Because when there’s no vested interest; there’s no ownership.

Similarly, most of us really don’t care how much medical procedures cost for the simple reason that we’re not vested. The fact is tht most of us have no idea how much medical procedures cost because the insurance company picks up the tab.

And therein lies the biggest problem with the Affordable Care Act (Obamacare): Congress’ failure to address the singular most important aspect of the issue — human nature.

It’s human nature to take pride in or put energy into things that benefit us directly, just as it’s human nature to disregard those things that don’t. It’s when people have no “skin in game” regarding the cost of medical procedures that costs get out of hand.

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One size doesn’t fit all

The notion that one size fits all regarding health care is patently ridiculous. During the health care debate, proponents used the argument that the United States was the only Western industrial nation without a system of national health care.

But that reasoning is flawed because the average industrialized nation in the Western world has a population of roughly 15 million people. National health care is far easier to manage in relatively homogenous nations such as Sweden (9 million), Denmark (5 million) or Switzerland (8 million) than in a heterogeneous nation of 320 million spread across 3,000 miles.

In retrospect, it should be easy to see why the Affordable Care Act was doomed from the start. Creating a one-size-fits-all health-care system in a nation as large and diverse as ours is akin to making a square circle — it’s just not possible.

The second biggest problem with the act was creating a law supported by only one political party. Those who justify the act passing without a single Republican vote compare Obamacare with Social Security and tell us people didn’t like Social Security at first but learned to love it. That type of reasoning is the ultimate in arrogance — it’s the ruling class telling Americans, “We know better than you.”

But if Congress really does know better than us, why is the nation $17 trillion in debt? The “we know better than you” attitude is a socialistic perspective, and we all know how well that worked for the Soviet bloc from 1945 to 1990.

But possible solutions should always accompany criticism, so what follows are a few suggestions regarding modifications that should be made to the Affordable Care Act:

1. First and foremost, the Affordable Care Act should apply equally to all American citizens, including the president and Congress.

2. Instead of spending the billions the act will cost taxpayers, Congress might give thought to empowering consumers by giving them a fixed amount of money annually that must be used for health care. This money should not be taxed and if there is any residual, the individual should be allowed to keep the difference, similar to what Mitch Daniels did with Indiana’s state employees, a program that was enormously successful.

3. It’s axiomatic that when competition is introduced, prices go down. To inject competition into the market place, insurance companies should be allowed to sell policies (and compete) across state lines.

4. The government should also create a blue ribbon committee made up of insurance industry experts with oversight by the SEC and the Senate Finance Committee to design a basic standardized insurance policy that includes preventive health care protocols. Congress could mandate that all health insurance carriers offer this basic policy in order that people are able compare policies on an apples-to-apples basis. After a basic policy is created, consumers should be given options to purchase additional or modify certain coverage, such as pregnancy benefits, dental, eye exams, etc., as well as making use of increased or reduced deductibles based upon on an individual’s preferences or needs.

5. To redress the problem of expensive and unnecessary tests and procedures as a matter of “defensive medicine,” the government could create a medical injury pool with congressional oversight to compensate people due to a physician’s omission, mistakes or accidents.

Funding this pool could be accomplished by adding a small tax to everyone’s insurance premiums. Such a policy would spread the cost of actual malpractice, eliminate the need for medical malpractice insurance and eliminate trial lawyers from the equation.

6. There must be financial incentives for living a healthy lifestyle, such as premium discounts for getting annual checkups and for doctors to practice more preventive medicine.

These are but a few ideas that could be easily implemented if only our legislators would put human nature back into the equation and ensure that everyone (including themselves) is vested in the outcome.

Quote of the day: “Our democracy will cease to exist when you take away from those who are willing to work and give to those who would not.”

Thomas Jefferson

Butch Mazzuca, of Edwards, writes regularly for the Vail Daily. He can be reached at

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